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A Medicaid and CHIP state plan is an agreement between a state and the Federal government describing how that state administers its Medicaid and CHIP programs. It gives an assurance that a state will abide by Federal rules and may claim Federal matching funds for its program activities. The state plan sets out groups of individuals to be covered, services to be provided, methodologies for providers to be reimbursed and the administrative activities that are underway in the state.
When a state is planning to make a change to its program policies or operational approach, states send state plan amendments (SPAs) to the Centers for Medicare & Medicaid Services (CMS) for review and approval. States also submit SPAs to request permissible program changes, make corrections, or update their Medicaid or CHIP state plan with new information.
Persons with disabilities having problems accessing the SPA PDF files may call 410-786-0429 for assistance.
Summary: Under this SPA, the State proposes to change the maximum prescription refills for a non-controlled drug from five refills with a six month expiration period to eleven refills with a one year expiration period. In addition, the State further defines the expiration date for valid prescriptions.
Summary: This state plan amendment establishes program criteria and reimbursement for mental health rehabilitation services for children and youth It eacpands services and changes substance abuse rehabilitation services.
Summary: This SPA amendment was required by Section 6411 of the Affordable Care Act pertaining to the Medicaid Recovery Audit Contractor (RAC) program. Effecting December 31, 2010, Louisiana is attesting that they are establishing a Medicaid RAC progrem. The amendment does not have a dired impact on tribes, and did not require a tribal consultation
Summary: The purpose of this amendment is to revise the provisions goveming the reimbursement methodology for nursing facilities to ensure that the provisions goveming private room conversions aze consistent with the increase in the fair rental value minimum occupancy percentage.
Summary: The purpose of this amendment is to increase the direct care and care related price multiplier and to increase the fair rental value minimum occupancy percentage for the calculation of nursing facilities payments.
Summary: Establishes home and community based services under the 1915(i) state plan option for Adult Behavioral Health Services concurrent with the Behavioral Health 1915(b) waiver under a capitated contract reimbursement methodology.
Summary: Revises the Medicaid reimbursement rate for a public over 50 bed intermediate care facility for persons with developmental disabilities that is transitioning to a private facility.
